Rural residencies could help solve coming doc shortage

KU Med vice chancellor sees role for community hospitals

0 | Rural Health, University of Kansas

Dr. Douglas Girod, the new executive vice chancellor of the University of Kansas Medical Center.

Dr. Douglas Girod, the new executive vice chancellor of the University of Kansas Medical Center.

— Rural hospitals could provide critical help addressing the state’s expected doctor shortage, according to Dr. Douglas Girod, the new executive vice chancellor of the University of Kansas Medical Center.

“This is one of those areas where if you really want to link physicians with where they need to be with funding of the educational enterprise…potentially community hospitals can step into the role,” Girod told KHI News Service.

KU officials also are planning a new $75 million medical education building on the Kansas City, Kan., campus to help train more doctors and are seeking funding help from the Legislature this year.

KU officials estimate Kansas will need 213 new doctors a year by 2030 just to maintain what is now a physician-per-resident ratio that lags the national average. To meet the national average ratio, Kansas would need about 285 new doctors a year by 2030.

Girod said community hospitals could help address doctor shortages in rural areas by funding residency slots through federal Medicare payments.

According to medical center officials, The University of Kansas Hospital pays for 280 residency slots, augmenting its federal funding with money from its clinical operations and with assistance to other hospitals

KU has 511 residency slots in Kansas City and 250 at its Wichita campus.

Kansas has done a good job trying to seed rural communities with more doctors, said Brock Slabach, senior vice president of the National Rural Health Association. He said KU’s campus in Salina was a good example of that.

National medical school accrediting bodies, Slabach said, worry about the training and oversight residents might receive in remote areas so have been reluctant to sign off on training programs outside metropolitan areas.

The federal government has also been slow to implement legislation authorizing rural training tracks, he said. And community hospitals have been reluctant to take on the responsibility because of the added costs of overseeing residents.

Though it can be hard to get them there, once young physicians arrive in smaller towns, they tend to energize the local medical communities.

“It stimulates the physicians in those communities,” he said. “They are challenged a bit in terms of their assumptions and what they have learned. They have someone coming out maybe with some different perspectives on things because of their more recent education.”

KU efforts to construct its new medical building hit a snag in the Legislature last week, when the Senate Ways and Means Committee voted to cut $10 million that Gov. Sam Brownback proposed for the project.

The House Appropriations Committee today approved the $10 million.

In his proposed two-year budget, Gov. Sam Brownback included $3 million in fiscal 2014 and $7 million in fiscal 2015 for KU's effort to build a new $75 million medical education building. The governor also endorsed giving the medical center $35 million in bonding authority for the project.

KU officials say they could train about 25 new doctors a year on the Kansas City campus after the improvements, and need the new facilities anyway or else the school's accreditation could be in peril.

Kathy Damron, a lobbyist for KU, said the facility is needed, in part, to integrate instruction of doctors, nurses and other medical staff, currently trained in separate facilities.

"It will allow the doctor to learn with the nurse, with the anesthesiologist and so on — all in a simulation lab. Right now, we train them all separately and throw them in the hospital and say 'now work together.' And that doesn't really work. That's the modality that schools of medicine are now moving to," Damron said. "The accreditors want to see that we're moving in the right direction to change the modality in which we're teaching our medical students.

Should the state funding come through, Girod said he was confident that KU could raise the $22 million it has pledged toward the building.

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The planned location for a new $75 million medical education building on the Kansas City, Kan., campus is the northeast corner of Rainbow Boulevard and 39th Street.

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He said he would like to have the building ready by 2017, constructed on what is now a parking lot at the northeast corner of northeast corner of Rainbow Boulevard and 39th Street.

“When (donors) think about how they want to invest their funds,” he said, “they want to invest in an area where they are going to see some pretty tangible results. And I think it’s very easy to see a very tangible result from (the building). It will impact generations and that is something that will excite some potential donors.”

Girod also touched on other topics during the interview, including:

• How KU’s recent National Cancer Institute designation helps its education mission: “That creates a culture of clinical, intellectual curiosity that already we are seeing synergies from.”

• The burgeoning relationship between KU and Children’s Mercy Hospitals and Clinics in Kansas City, Mo.: “The potential for that collaboration to grow the research enterprise for both of our organizations is immense and it’s wonderful clinically and it’s great for the kids and it’s great from an education perspective.”

• Status of the proposed School of Public Health: “We have had the work group looking at the combination of feasibility, structure and then financing and we are working down that list. It’s a unique school in that it will involve several campuses…which is a much more dispersed model than a lot of places. It creates challenges but it also creates opportunities because each has different strengths, in part because each sits in a different part of the state.”

Reporter Phil Cauthon contributed to this report.

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